• Seven patients undergoing aphakic keratoplasty or combined keratoplasty and cataract extraction were fitted with a single type of high-water-content, extended-wear, aphakic soft contact lens (Permalens). Six patients were fitted early after keratoplasty, ie, before the removal of the sutures and while they were still receiving corticosteroid drops (1% prednisolone acetate). The patients were followed up at close intervals with highmagnification serial corneal photography. Complications of extended wear included superficial neovascularization, punctate epithelial keratitis, and variable visual acuity. Our results suggest that although extended-wear aphakic soft contact lenses may be an acceptance form of visual rehabilitation in selected patients who undergo transplantation, they are frequently problematic. In addition, fitting of these lenses should be withheld until after the removal of the sutures, and patients should be followed up at closer intervals than the patients with extendedwear aphakic soft contact lenses who have not undergone keratoplasty.